IS OPERATING-ROOM RESUSCITATION A WAY TO SAVE TIME

BACKGROUND: Direct admission to the operating room (OR) can shorten th e time to incision. A protocol for operating room resuscitation was es tablished with patient triage based on (1) cardiac arrest, (2) hypoten sion unresponsive to field fluid resuscitation, or (3) uncontrolled ex ternal hemorrhage. METHODS: Operating room resuscitation over 11 years was reviewed to determine whether the triage criteria correctly ident ified patients requiring operation. Survival was analyzed and compared with the probability of survival (P-s) determined at the scene. RESUL TS: Operating room resuscitation patients were more likely to require a major operation regardless of mechanism of injury. Of 476 patients w ith penetrating injury, 170 patients had persistent low blood pressure (<90 mm Hg), and 146 (85.9%) of these required major operative interv ention. The mean time to incision in this group was 21.7-67.5 minutes less than for patients not receiving OR resuscitation. Observed surviv al was significantly greater than that predicted for this group. CONCL USIONS: Field triage criteria are able to reliably identify patients w ho require immediate major operative intervention. Direct admission to the OR results in a more timely initiation of operative therapy for p atients requiring emergency surgical procedures. (C) 1997 by Excerpta Medica, Inc.